Other Benefits
Weekly Disability Benefit
Your TeamstersCare Weekly Disability Benefit is designed to pay you a weekly benefit while you’re disabled. The disability must be caused by a sickness or injury that is not related to your job. All disability claims are subject to review by the TeamstersCare Disability Panel.
The Weekly Disability Benefit also includes maternity as an eligible disability for however long it’s medically necessary for you to be out of work. Generally, “medically necessary” means your physician determines that your pregnancy, or a condition arising out of your pregnancy, prevents you from performing your job.
Important Note: If you are a UPS part‐time benefit member, you are not eligible for TeamstersCare weekly disability benefits, except when you work 400 or more hours in an eligibility determination period (see page 9 for details on UPS Part‐time Benefits).
Your Disability Coverage
If you have a disability not caused by your job but which keeps you from working, the TeamstersCare Weekly Disability Benefit pays you a benefit each week, for up to 26 weeks, after a seven‐day waiting period. In order to be eligible, you must submit the appropriate form (available from Charlestown Member Services) completely filled out by you, your employer, and your doctor.
In order to receive Weekly Disability Benefits, you have to be under the care of a medical doctor, physician’s assistant, nurse practitioner or licensed mental health provider. Also, during your disability, TeamstersCare may require your provider to fill out an Extension of Benefits Form, which will then be reviewed by the TeamstersCare Disability Panel.
If approved by the TeamstersCare Disability Panel, your weekly disability benefit equals 75% of your regular weekly base pay, from a minimum of $300 per week up to a maximum of $600 per week. In no event can this benefit be greater than 100% of your average weekly pay. TeamstersCare uses your most recent eligibility determination period to calculate your base pay.
The Government considers disability benefits—to which you do not contribute—taxable income.
TeamstersCare deducts the appropriate FICA tax from your check and mails you a W‐2 form at the end of the year. You may elect to have taxes deducted from your weekly disability check by submitting a written request to TeamstersCare, listing the amounts to be deducted.
Important Notes:
Your TeamstersCare disability benefit will be reduced by any disability‐related payments you might receive from Workers’ Compensation, state disability, an auto insurance carrier or any other group plans.
The maximum weekly disability benefit you may collect is 26 weeks from the date of injury.
Any payments you receive from Workers’ Compensation or an automobile insurance carrier count toward this 26‐week maximum.
The Fund makes disability payments only so long as a member is working for a contributing employer and remains eligible according to the eligibility and participation provisions of the TeamstersCare Plan. Like other TeamstersCare benefits, weekly disability payments are discontinued when, for whatever reason, a member loses eligibility.
Disability Waiting Period
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After a seven‐calendar‐day “waiting period,” your benefit payments start on the eighth day you’re disabled and may be extended for up to 26 weeks with appropriate documentation of proof of disability.
The seven‐day waiting period begins on one of two days, depending on when you visit your doctor and have your disability verified:
" If you visit the doctor and receive verification anytime within the first three days of the day you became disabled, the seven‐day waiting period begins on the first day you were disabled.
" If you do not see your doctor and receive verification within three days after you’re disabled, then your seven‐day waiting period starts three days before your first doctor’s visit.
More Than One Period of Disability
TeamstersCare pays benefits on a per‐disability basis. This means you can receive up to 26 weeks of benefits each time you’re disabled. In order for two periods of disability to be treated as separate, you must have actively, physically returned to work for at least two weeks between the end of the first period of disability and the beginning of the second period of disability. So, for example, you could not use vacation time or sick time to “bridge the gap” between the two disability periods.
If you go back to work for fewer than two weeks after a disability ends, and you become disabled again for the same or a related condition, then your second period of disability will be considered an extension of the first. However, you would not have to meet another seven‐day waiting period, and you could continue to receive benefits for up to the remainder of the original 26‐week period.
In certain unusual situations, such as a member who is disabled intermittently due to scheduled recurring chemotherapy or radiation treatment for cancer, the seven day waiting period need not be seven consecutive days. In these unusual situations, the TeamstersCare Disability Panel will examine submitted medical documentation to determine if the episodes of disability are part of the same medical disability and meet the necessary criteria. If the Committee approves, the waiting period may be counted as seven calendar days that are not consecutive and the requirement of returning to work for more than two weeks necessitates an additional seven‐calendar‐day waiting period will be waived.
Continuing TeamstersCare Medical Coverage While Disabled
If you’re disabled and are receiving either TeamstersCare Weekly Disability benefits (for a non‐work‐
related disability) or Workers’ Compensation (for a work‐related disability), you may be able to continue receiving TeamstersCare medical benefits during the period of your disability. In either case, you must meet all of the Plan’s eligibility rules.
Non‐Work Related Disability
If you’re disabled from a non‐work‐related injury and are receiving TeamstersCare Weekly Disability benefits, you may be eligible to continue your TeamstersCare medical benefits.
After the seven‐day waiting period, for the first four weeks you’re disabled, your employer contributes to TeamstersCare at the rate of 32 hours per week. After those four weeks, TeamstersCare will credit you with hours toward continuing eligibility at a rate of 32 hours per week, for up to 22 weeks. If you worked an average of fewer than 32 hours per week during your most recent eligibility determination period, TeamstersCare will credit you with the average number of hours you worked per week.
You cannot be credited with a total of more than 800 “disability” hours in any consecutive three‐year period.
Work‐Related Disability
If you’re disabled from a work‐related injury and are receiving Workers’ Compensation, you may be able to maintain your TeamstersCare medical coverage so long as you meet all of the Plan’s eligibility
requirements and your employer continues to contribute to TeamstersCare at a rate of 32 hours per week (17.31 hours for UPS part‐timers). Contributions are made in accordance with the Collective Bargaining Agreement between the Union and your employer. In most cases contributions will continue for up to 12 months.
Disputed Work‐Related Disability
If you’ve filed a Workers’ Compensation claim which is disputed by your employer or the Workers’
Compensation carrier, then—during the period when the claim is being adjudicated—TeamstersCare may pay you a weekly disability benefit provided:
" you sign a notarized Assignment and Consent to Lien Agreement committing to repay any amounts you have received from the Plan should you (1) become eligible for Workers’ Compensation benefits or (2) receive proceeds from a Workers’ Compensation claim
" you provide TeamstersCare with a copy of the Workers’ Compensation denial
" you complete a TeamstersCare Third‐Party Questionnaire Form
Important Note: During the period when you are disabled from a work‐related injury or illness and you’re receiving Workers’ Compensation, TeamstersCare does not cover any medical or pharmacy expenses that are attributable to the injury or illness. In addition, the maximum weekly disability benefit that you may collect is 26 weeks from the date of injury. Any payments that you receive from Workers’
Compensation count toward this 26‐week maximum.
Continuing Life Insurance While Disabled
If you become totally and permanently disabled while you’re covered by TeamstersCare life insurance, but then lose your eligibility for benefits, your life insurance may remain in effect for a certain period of time, provided you continue to be totally disabled. There will be no cost to you. TeamstersCare will pay the premiums on your behalf. The length of time this extended coverage remains in effect depends on how old you are when disability begins (see page 40 for details on Life Insurance Benefits If You’re Disabled).
Important Note: “Totally and permanently disabled” means that your disability prevents you from working at any kind of paying job you would normally be qualified to do.
Disability TeamstersCare Does Not Cover
TeamstersCare does not provide benefits for job‐related medical expenses or job‐related disabilities which are eligible for coverage by Workers’ Compensation, state disability laws, no‐fault insurance or other group plans.
Disability Resulting from Motor Vehicle and Motorcycle Accidents
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If you have a disability claim related to a motor vehicle or motorcycle accident, you, or someone acting on your behalf, must notify TeamstersCare as soon as possible. The Plan’s coverage varies with a number of factors.
States Requiring Mandatory No‐Fault Insurance
If you live in Massachusetts, or any other state with no‐fault insurance, disability claims resulting from a motor vehicle accident are covered by mandatory no‐fault insurance. If you are covered by such insurance and you are in a motor vehicle accident, then TeamstersCare will not pay weekly disability for any week in which you also receive insurance payments. However, if you reach the no‐fault maximum before the 26th week that you’re disabled, TeamstersCare may pay benefits for up to the rest of the 26‐week period.
If you have elected not to carry no‐fault coverage, and you have a disability claim resulting from a motor vehicle or motorcycle accident, TeamstersCare excludes from your benefits all amounts that would have been covered had you obtained no‐fault insurance.
States Without No‐Fault Insurance
If you live in a state that does not require mandatory no‐fault coverage, the Plan will administer motor vehicle or motorcycle accident claims in the same way as any other disability claim. However, you’ll first have to sign an Assignment and Consent to Lien Agreement which requires that if you receive any third‐
party settlements related to the accident, you’ll be required to reimburse TeamstersCare an amount equal to any payment the Plan may have made on your behalf.
For coverage of medical claims resulting from motor vehicle accidents, see Third Party Liability on page 59.
Important Note: If you are denied benefits under your motor vehicle insurance due to driving under the influence, TeamstersCare excludes from your benefits all amounts that would have been covered by the insurance carrier.
Other Disability Settlements
In general, if you receive a settlement to compensate you for a disability, you must reimburse
TeamstersCare for any medical and disability benefits the Plan may have paid you for that same disability.
If you’re disabled and are receiving disability payments from a third party, your hours continue to accrue towards your continuing eligibility for TeamstersCare medical coverage—just as they would if
TeamstersCare were making your disability payments.
Filing a Weekly Disability Claim
If you need a Weekly Disability Claim Form, call Charlestown Member Services. Fill out your portion of the Form, and then have your employer and medical doctor complete their respective portions. You must return the completed Form to TeamstersCare within 90 days of the date your disability begins. If you do not return the Form within 90 days of the date your disability begins, you will not be eligible for disability benefits.
The TeamstersCare Disability Panel will review the information you provide and will contact you if you, your employer, or your medical doctor needs to provide more information.
Important Note: Disability payments cannot begin until you’ve submitted a properly documented claim that’s been approved by the TeamstersCare Disability Panel.
Information You Must Provide to be Eligible for Weekly Disability Benefits TeamstersCare cannot pay weekly disability benefits without obtaining all the information it needs to process your claim.
" When you first have a claim, you must, within 90 days of the date your disability begins: (1) submit the appropriate Disability Claim Form, (2) sign a Release of Information Form, and (3) provide TeamstersCare with a pay stub.
" In order to begin or continue your weekly disability benefit, TeamstersCare may need to review certain documents related to your disability. This could include such items as doctor’s office notes and supporting data such as x‐rays, MRI’s, etc.
" For prolonged periods of disability, TeamstersCare may require your physician to fill out an Extension of Benefits Form, which will then be reviewed by the TeamstersCare Disability Panel.
" When your disability is over and you return to work, you must notify TeamstersCare immediately.
Teamsters Union 25 Health Services & Insurance Plan will take all necessary steps to recover any benefits it pays out because of late or improper notification.
" If you would like federal and state taxes withheld from your disability check, notify Charlestown Member Services.
Important Note: If you work while out on disability and you have not been cleared to return to work by the doctor who treated your disability, your TeamstersCare weekly disability benefits end.